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Query: UMLS:C0027497 (nausea)
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Meckel's diverticulum is the most prevalent abnormality of the gastrointestinal tract seen in approximately 2% of the population. Diagnosing complicated diverticulum is difficult, for its capacity to mime multiple disorders such as appendicitis, ulcer disease, enterocolitis, Chron disease, sigmoid diverticulitis, cholecystitis, and it should be considered in all patients with unexplained chronic abdominal pain, nausea, vomiting, gastrointestinal bleeding, unexpected cause of intestinal obstruction or acute abdomen. Herewith we provide an illustrative presentation, emphasizing the difficulties in preoperative diagnosis of complicated Meckel's diverticulum and underlining the nonspecific nature of the subjective and objective findings. Both cases were admitted to our clinic with acute abdomen diagnoses--first case as a intestinal obstruction and in second case was acute appendicitis. Laparatomy ascertain that the cause of symptoms was the complicated Meckel's diverticulum.
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PMID:[Complicated Meckel's diverticulum in adult pathology]. 2018 76

We present a case of a 66-year-old man, who was admitted with a 6-hour history of severe diffuse abdominal pain of acute onset, accompanied by nausea and flatulence. The patient underwent an exploratory laparotomy, which revealed the presence of multiple diverticules of the jejeunum, one of which was ruptured. The patient was treated with segmental resection of the jejunum carrying the ruptured diverticle. Perforation of a jejunal diverticulum has to be considered in the differential diagnosis of acute abdomen.
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PMID:Perforated jejunal diverticulum presenting as acute abdomen. 2040 92

Small bowel perforation is a rare complication of femoral artery access in cases of femoral hernia. A 48-year-old woman was admitted to the intensive care unit due to pulmonary insufficiency. After a routine femoral arterial blood gas analysis, severe abdominal pain and nausea began. She underwent emergency laparotomy due to acute abdomen. Laparotomy revealed small bowel perforation. Segmental resection and end-to-end anastomosis were performed. The femoral canal was closed using plaque mesh. Special attention is needed during femoral artery access to avoid accidental small bowel perforation. As seen in this case, a careful examination should be done in cases of femoral hernia.
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PMID:Small bowel perforation after drawing a blood sample in the femoral artery: a case report. 2051 57

Systemic Lupus Erythematosus (SLE) is an autoimmune disease, with multisystemic involvement. Gastrointestinal symptoms are common, like nausea, vomiting and dyspepsia. Acute pancreatitis is an unusual manifestation of SLE, being an important differential diagnosis in evaluation of abdominal pain. The patients usually presents with pain of variable intensity, some occasions simulating acute abdomen. Several factors have been implicated in the pathogenesis of this condition, such as vasculitis, drugs and antiphospholipid antibodies. The role of corticosteroids as etiologic factor remains controversial. Due to the rarity of SLE associated to pancreatitis, we report two cases of patients with severe inflammatory process. In one case, it was used corticosteroids in high doses during treatment, with good outcome. In another, the patient died because of pancreatic pseudocyst rupture and its postoperative hemodynamic complications. In the reported cases, predisposing factors for acute pancreatitis were not verified, so it was considered a primary manifestation of SLE activity.
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PMID:[Acute pancreatitis and spontaneous rupture of pancreatic pseudocyst in systemic lupus erythematosus]. 2071 Oct 96

We report a case of adult intestinal intussusception. The patient had complained of intermittent nonspecific abdominal pain and nausea for two weeks, when acute abdomen appeared and required a segmental small bowell resection. During hospitalization in our Department three abdominal ultrasound examinations were performed, but only one of which was useful in making the diagnosis. We stress the role of ultrasound imaging in the diagnosis of intussusception in adults.
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PMID:[Intestinal intussusception in adult. Abdominal ultrasound is useful as diagnostic method, if correctly assessed]. 2113 75

An eighty-year-old female was transferred to the hospital after experiencing abdominal pain and nausea. She had had a history of total gastrectomy for gastric cancer 14 years previously. Abdominal X-ray revealed a localized expansion of the small bowel. Computed tomography revealed a mass with a lamellar structure in a concentric circle. With a tentative diagnosis of small bowel obstruction due to intussusception, she underwent emergency operation. Laparotomy revealed a retrograde jejuno-jejunal intussusception. Bowel resection was performed due to the severe ischemic damage. All reported intussusception cases after total gastrectomy displayed retrograde characteristics and could occur both during the early and late period after surgery. It is important to consider the possibility of intussusception for patients presenting with acute abdomen who have previously undergone gastric resection.
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PMID:Retrograde jejuno-jejunal intussusception after total gastrectomy. 2149 Aug 99

Hematoma or abscess of the liver ligaments is extremely rare, and hematoma of the falciform ligament has been sporadically reported. We report the case of a 70-year-old female who presented with a three-day history of right upper quadrant abdominal pain, fever and nausea. With a preoperative diagnosis of probable perforated acalculous cholecystitis, the patient underwent emergency surgery. Hematoma of the falciform ligament was found. Wide excision of the falciform ligament including the hematoma with abscess was performed. Although pathology of the falciform ligament is rare, it should be included in the differential diagnosis of acute abdomen, especially in the case of antiaggregant drug usage.
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PMID:Hematoma of the falciform ligament: a rare cause of acute abdomen. 2179 63

Acute appendicitis presents typically with periumbilical pain that in a few hours settles at the right lower quadrant of the abdomen. Atypical presentations are common but association with acute scrotum is an extreme rarity. A 30-year-old fisherman presented at a rural medical facility with a 2-day complaint of severe pain at the right hemiscrotum followed about 24 hours later with mild diffuse abdominal pain. There was associated mild fever and nausea but no vomiting. There were no urinary symptoms and no recent sexual exposure. Initial physical examination revealed mild generalized tenderness worse at the right lower quadrant but the scrotum was not remarkable, and cremasteric sign was negative. He was admitted as a case of acute abdomen for close observation. Abdominal and scrotal ultrasound scan were normal. By the second day of admission, pain became marked at the right lower abdomen with associated vomiting. There was also marked tenderness at the right lower quadrant with rebound. A diagnosis of acute appendicitis was thus made and appendicectomy done after proper workup. The abdominal and scrotal pain stopped after surgery and the patient was discharged on the seventh postoperative day. Patients with unusual abdominal and scrotal pain should be admitted and closely observed and evaluated to prevent unnecessary scrotal exploration or negative appendicectomy.
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PMID:Acute appendicitis masquerading as acute scrotum: a case report. 2181 59

The article presents the case of a male patient, hospitalized due to severe pain in the upper abdomen area, nausea, and vomiting. The patient was diagnosed with surgical acute abdomen, for which emergency surgery is performed. Upon penetration into the peritoneal cavity, stomach inspection shows at the medio-gastric level, on the greater curvature, a callous gastric ulcer, with a central perforation. A large excision is decided up to the healthy (normal) gastric tissue, and the resulting pieces are sent to the pathological anatomy laboratory. The histopathological exam reveals signet ring cell recent gastric carcinoma. The biopsy performed 1 month after surgery, prelevated from the antropyloric zone, reveals antropyloric gastritis with moderate activity and Helicobacter pylori positive. Due to the fact that such cases when this gastric cancer type is diagnosed in recent stages are extremely rare, we considered it useful to present it and look into its macroscopic and microscopic aspects, as well as into the differentiating diagnosis.
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PMID:[Clinical and morphological features in a case of recent gastric carcinoma (the signet ring cell carcinoma type)]. 2185 50

Pancreatitis indicates inflammation of the pancreas. Clinically acute pancreatitis typically presents as upper abdominal pain mostly in epigastric region, nausea, vomiting and elevated levels of amylase and lipase. Depending upon severity of acute pancreatitis patient may presents with minimal symptoms to more severe signs of acute abdomen like generalized guarding and rigidity. Inspite of absence of disease-specific signs and symptoms for acute pancreatitis, diagnosis is usually not difficult using a combination of clinical, laboratory and radiological findings. Sometimes pancreatitis may presents atypically, which may be misleading in the management especially when typical presentation of pancreatitis as described above is absent. We have described a case of pancreatitis where patient presented with anterior abdominal wall abscess with epididymo-orchitis because of tracking of pancreatic fluid into the retroperitoneum till scrotum. Patients presentation may be different depending upon complication occurred during the course of pancreatitis. After reviewing the literature we found very few cases in which you may not get a clue to diagnose pancreatitis because of atypical presentation. In the described case, patient managed conservatively with percutaneous drainage of the abscess by pigtail catheter placement and scrotal support for epididymoorchitis. This avoided unnecessary exploration in above patient.
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PMID:Anterior abdominal wall abscess with epididymo-orchitis: an unusual presentation of acute pancreatitis. 2212 Aug 65


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